| Objective:To compare the comprehensive control of T2 DM in Shihezi Community by Shihezi City community,and to analyze the comprehensive control of T2 DM patients in Shihezi Community from 2014 to 2017;to observe the changes of life and behavior patterns of T2 DM patients;to understand the screening of chronic complications in T2 DM patients Situation;to provide a basis for the study of comprehensive management measures for community diabetes patients,to create and continuously improve the T2 DM community integrated management system.Improve the standardized management rate of T2 DM in the region,the compliance rate of each indicator,reduce the incidence of complications,further improve the health of residents and reduce the burden of living.Methods:In November 2014,T2 DM patients from 13 communities under the jurisdiction of the First Affiliated Hospital of Shihezi University Medical College used questionnaires to collect general information,related medical history,life and behavioral habits,and related laboratory indicators and concurrent Obtain screening baseline data,use Epidata3.1 software to establish database entry data;develop relevant management measures to comprehensively manage the above-mentioned patients for three years,conduct the above-mentioned survey(same baseline)for patients in November during the comprehensive management period and complete the database.After the final survey was completed in November 2017,a total of 236 T2 DM patients with consistent and complete data were collected from the established database.SPSS 25.0 software was used for statistical processing,and the behavior of T2 DM patients during life management was compared and analyzed.Changes in methods,biochemical indicators and screening for complications.Results:(1)Changes in life and behavior patterns of T2 DM patients: Through continuous comprehensive management,the proportion of patients who can perform monthly blood glucose monitoring increased from 28.89% before management to 48.73% after management.The regular medication was increased from 68.64% before management to 87.71% after management,the difference was statistically significant(P<0.05);the number of smokers decreased from 20.76% before management to 12.29% after management;The proportion of exercise for more than half an hour increased significantly from 57.20% to 73.73%.There were significant differences in smoking status and exercise before and after exercise(P<0.05).(2)Comprehensive control of patients with T2DM: After three years of comprehensive management,the FBG and HbA1 c levels decreased compared with those before management(P>0.05).After three years of management,systolic blood pressure increased and diastolic blood pressure decreased(P<0.05).The levels of total cholesterol,high-density lipoprotein and low-density lipoprotein were better than those before management(P<0.05).The blood glucose and blood lipids of the males were better than those before management(P<0.05).The blood pressure of male and female patients was up to standard.The situation was higher than before management(P<0.05);before and after management,blood glucose + blood pressure,blood lipid + blood pressure,blood glucose + blood lipid + blood pressure reached the standard,which was higher than that before management,but blood lipid + blood pressure increased more significantly(P<0.05).(3)Screening of complications in patients with T2DM: In 2014-2017,the screening for DR patients was 25.85%,35.59%,35.44%,and 39.44%,respectively.This proportion increased year by year,the course of disease in the DR group,age,Glycated hemoglobin and blood glucose at 2 hours after meal were higher than those in NDR group(P<0.05);the risk of foot ulcer increased from 74.58% before management to 91.95% after management(P<0.05),and the age of foot ulcer risk group,The blood pressure of diastolic blood pressure and 2 hours after meal was higher than that of the risk of no foot ulcer(P<0.05).The abnormality of urine microalbumin screening in 2014-2017 accounted for 35.59%,33.05%,26.69% and 26.27%,respectively.The trend is decreasing year by year(P<0.05).Conclusions:Diabetes comprehensive management measures for T2 DM patients enrolled in 13 communities in Shihezi City:(1)the improvement of lifestyle changes(self-test blood glucose,medication compliance,smoking,exercise);(2)biochemical indicators(blood pressure)The rate of compliance with blood lipids was significantly increased.(3)The screening index of early diabetic nephropathy also showed an improvement trend,but there was no delay in the development of diabetic retinopathy and diabetic foot disease. |
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